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This will change my practice!
#RCT #MMF + #MTX
superior to
#Cyclophosphamide then #Azathioprine
In
#Tayakasu’s #arteritis N=150
RCT ~1g BID #mycophenolate + 15mg/wk #Methotrexate
Vs #cyclo ➡️100mg #azathioprine
All got #glucocorticoids
#ACR24 @RheumNow @ACRheum #1696 https://t.co/OpRep1vsmx
Janet Pope Janetbirdope ( View Tweet)
Safer and less relapses in
#Takayasu’s #arteritis
In
#MTX + #MMF
Vs
#Cyclo ➡️ #azathioprine
@RheumNow #ACRBest @ACRheum abst#1696
WOW 😮 Amazing! https://t.co/y3BDjdAa6P
Janet Pope Janetbirdope ( View Tweet)
Can we use MTX+MMF to treat active #TAK rather than CYC?
➡️MTX+MMF vs CYC/AZA over 52W
MTX+MMF had:
⬆️Better efficacy in inducing & maintaining remission
❕Comparable safety to CYC/AZA
⏩This combination may prove preferable to using CYC
Ab1696 #ACR24 @RheumNow https://t.co/S0A8YNk3qL
Mrinalini Dey DrMiniDey ( View Tweet)
#Methotrexate is a dud in #PMR for benefit above #glucocorticoids !
#RCT MTX25mg/wk + Pred 15
Mg/d tapered to 0 at 1 yr vs #Prednisone + placebo same taper
NO BENEFIT from #MTX
#1697 #ACR24 @ACRheum @RheumNow
As FYI
Poster at #EULAR observed
#Leflunomide better than #MTX https://t.co/RepBmOKIsA
Links:
Janet Pope Janetbirdope ( View Tweet)
Very neat simulated model of GC regimens in AAV pt on fixed RTX by @zach_wallace_md and co
Over 5 years:
- No difference in relapse btwn standard GC vs. minimal GC + avacopan
- Higher DMII rates in standard group
Adds to trial + real world data
@RheumNow #ACR24 Abst 1598
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Belimumab, anifrolumab and voclosporin exhibited an increase in claims from 2017-2022 for #SLE
Belimumab ~ 600% increase!!
@RheumNow #ACR24 abst#1259 https://t.co/norl1xk2KF
Bella Mehta bella_mehta ( View Tweet)
#SLE treatments #ACR24:
Compared efficacy & safety of belimumab vs. telitacicept (targets B-lymphocyte stimulator (BLyS) and proliferation-inducing ligand(APRIL))
Both improved disease activity with no difference in efficacy
Belimumab had lower infection rates
@RheumNow abst1544
Bella Mehta bella_mehta ( View Tweet)
More data from PAISLEY, deucravacitinib in SLE
Small but significant benefit w/respect to joints, a little disappointing tbh
Would like to see this for all manifestations ie pericarditis, pleuritis, etc
Anyone have an infographic or useful chart?
#ACR20 @RheumNow Abstr#1552 https://t.co/tXUoUtssxo
Links:
Mike Putman EBRheum ( View Tweet)
Low uptake of SGLT2i in Lupus nephritis
SGLT2i users had similar adverse event rates as ACEi/ARB users
SGLT2i users experienced more weight loss
#ACR24 @rheumnow abst#1534 https://t.co/tB5o7tyhu5
Bella Mehta bella_mehta ( View Tweet)
Study on SLE treatments:
Compared adverse events of anifrolumab vs. belimumab
Similar risks for mortality, sepsis, herpes zoster, dialysis, MACE, PE/VTE, COVID-19, URI, pneumonia, and mental illness #ACR24 @RheumNow abst#1527
Bella Mehta bella_mehta ( View Tweet)
Alright help me out here; this is pretty implausible, right?
Why would be pts be 11% more adherent to UPA? What's the bio-plausibility here? UPA 10% better than other JAKs?
Could do a network meta analysis; betting this doens't replicate
#ACR24 @RheumNow Abstr#1362 https://t.co/vpPq3vu9Wf
Links:
Mike Putman EBRheum ( View Tweet)
No Increase in Cardiovascular Events with JAK Inhibitors in IBD Patients
UMKC researchers have compared the use of JAK inhibitors versus tumor necrosis factor (TNF) blockers in inflammatory bowel disease (IBD) patients, but failed to see an increase in major adverse… https://t.co/IOzckJIfYf https://t.co/8S6FnffVLG
Dr. John Cush RheumNow ( View Tweet)
TYK2/JAK1 in Dermato? Interesting pre-clinical study of brepocitinib... but we really just need clinical data
Glad to see this is headed straight to a Phase 3! Hoping they allow IVIG: has been a problem with many/most/all? recent dermato studies
#ACR24 @RheumNow Abstr#0882 https://t.co/KS8fTMBpPR
Mike Putman EBRheum ( View Tweet)
Which RA patients are at increased risk of JAKi adverse events? Does disease activity matter?
in the upadacitinib ph3 trials, high disease activity pts had more:
serious infections
HZ
MACE
VTE
Active RA is a massive contributor to many AEs in JAKi pts
#ACR24 ABST1393 @RheumNow https://t.co/DlFf9Sfbja
David Liew drdavidliew ( View Tweet)
Zhang @jeffsparks et al. Even more evidence that MTX does not cause ILD, and in fact prevents ILD, in RA, OR 0.48 in meta-analysis. @RheumNow #ACR24 Abstr#1384 https://t.co/YvQnmmvNjF https://t.co/crYUwHahDb
Links:
Richard Conway RichardPAConway ( View Tweet)
STAR trial of GC w/d in RA LDA
SEMIRA of GC w/d controlled RA on Toci
Very slight disease activity increase, but higher flares
No symptomatic adrenal insufficiency, but data of abnormal ACTH stim
No good evidence of steroid w/d symptoms
Beth Wallace
@RheumNow #ACR24 https://t.co/j6UPWlVNIu
Links:
Eric Dein ericdeinmd ( View Tweet)
Slick poster, but must be careful w/real world data. Big risk of confounding/channeling bias
Pts with MACE risk (not always well-characterized by ICD codes) also less likely to receive JAK & therefore less liekly to have subsequent MACE
#ACR24 @RheumNow Abstr#1394 https://t.co/lilU0byJ1s
Mike Putman EBRheum ( View Tweet)
Getting more data on using deucravacitinib for PsO/PsA manifestations
Impressive effect on scalp psoriasis (which often means a lot to patients)
Given how safe it is, it's increasingly tempting to use more of it in mild-mod PsA
#ACR24 PSORIATYK SCALP trial ABST1137 @RheumNow https://t.co/vxS3RSlIN0
David Liew drdavidliew ( View Tweet)
What do current national/international rheumatology association guidelines say about perioperative discontinuation of biologics?
it's highly, highly variable
no wonder people get confused!
#ACR24 ABST1037 @CatherineL_Hill @RheumNow https://t.co/cmJ3qKU1QT
David Liew drdavidliew ( View Tweet)
Serrano-Combarro et al. Case series of upadacitinib in RA-ILD. 18 patients. Report stable/improved dyspnoea and HRCT over 12 months. PFTs shown, relatively stable @RheumNow #ACR24 Abstr#1372 https://t.co/yncy0lPq60 https://t.co/mrDMtEDwUt
Links:
Richard Conway RichardPAConway ( View Tweet)
